Industry Payments to Pediatric Orthopaedic Surgeons Reported by the Open Payments Database: 2014 to 2017

Abstract

Background: The Open Payments Database (OPD), mandated by the Sunshine Act, is a national registry of physician-industry transactions. Payments are reported as either General, Research, or Ownership payments. The current study aims to investigate trends in OPD General payments reported to pediatric orthopaedic surgeons from 2014 to 2017. Methods: General industry payments made to pediatric orthopaedic surgeons (as identified by OPD) were characterized by median payment, payment subtype, and census region. As fewer Research and Ownership payments were made, only payment totals for these categories were determined. General payment data were analyzed for trends using the nonparametric Mann-Whitney U test. Results: For General payments, there was an increase in the number of compensated pediatric orthopaedists from 2014 to 2017 (324 vs. 429). Of those compensated, there was no significant change in median payment per compensated surgeon ($201 vs. $197; P=0.82). However, a large percentage of total General payment dollars in pediatric orthopaedics were made to the top 5% of compensated pediatric orthopaedists each year (average 71% of total General industry compensation). For this top 5% group, median General payment per compensated surgeon increased from 2014 ($14,624) to 2017 ($32,752) (P=0.006). A significant increase in median subtype aggregate payment per surgeon was observed in the education (P<0.001) and royalty/license (P=0.031) subtypes; a significant decrease was observed for travel/lodging payments (P=0.01). Midwest pediatric orthopaedists received the highest median payment across all years studied. Few payments for research and ownership were made to pediatric orthopaedists. Four-year aggregate payment totals were $18,151 and $3,223,554 for Research and Ownership payments, respectively. Conclusions: Many expected payments to surgeons to decrease when put under the public scrutiny of the OPD. Not only was this decrease not observed for General payments to pediatric orthopaedic surgeons during the 2014 to 2017 period, but also the median General payment to the top 5% increased. These findings are important to note in the current era of increased transparency. Level of Evidence: Level III.

Analysis of payments to GI physicians in the United States: Open payments data study

“…10,11,15 In a study by Pathak et al looking into payments to pediatric orthopedic surgeons, 0.07% of payments were for research, and 0.2% were for ownership, with the remaining total going toward general payments. 15,29 These findings may be due to specific preferences in spending patterns by different companies. It could also be a result of the wide variety of payments that are included within the general payments category.…”

Trends in reported industry payments to physicians practicing cardiac electrophysiology from 2013 to 2018 in the United States

“…As can be seen in other subspecialties, the advent of Open Payments did not necessarily lead to a decrease in payments and, in fact, showed an increase in payments to the top 5% of providers in other specialties 10 . This trend toward increased total payments to the top 5% of providers was not seen in CE where the trend was largely flat.…”

Orthopaedic Foot and Ankle Surgeon Industry Compensation Reported by the Open Payments Database

“…This distribution by category was found to be similar to other subspecialties in orthopaedic surgery such as pediatric orthopaedics. 15 However, this distribution was different from payments overall in the OPD, in which greater than 94% of the total industry payment value was classified as General. 5…”

“…That said, the median payment and number of compensated surgeon findings are similar to results reported in otolaryngology, 13 oral/maxillofacial surgery, 23 and pediatric orthopaedic surgery. 15 With the above said, the majority of total orthopaedic F&A industry dollars were made to the top 5% of compensated orthopaedic F&A surgeons. When considering this subgroup of surgeons by year, there was a significant increase in median payment over the 4-year period.…”

“…In other disciplines, more recent data from the OPD have been analyzed to assess trends over time. 13-15 For instance, in urology, it was found that the number of surgeons with industry relationships stayed similar, but total payments went down between 2014 and 2016. 13 Additionally, an evaluation of the OPD in plastic surgery showed a decrease in the number of plastic surgeons holding industry ties and a reduction in total payment from 2013 to 2014.…”